Sub-Saharan Africa has the highest level of food insecurity in the world. An estimated 220 million people lack adequate nutrition. The nature of the problem is shifting rapidly, with overweight status and obesity emerging as new forms of food insecurity while malnutrition persists. But continental policy responses do not address this changing reality.

Food insecurity is the outcome of being too poor to grow or buy food. But it’s not just any food. According to the United Nations’ Food and Agriculture Organisation’s definition, people need:

… sufficient, safe, nutritious food to maintain a healthy and active life.

Current policy focuses on alleviating undernutrition through increased production and access to food. It does not focus on the systemic issues that inform the food choices people make. This may result in worsening food insecurity in the region.

It has been three months since the earthquake in Nepal. Over 9,000 people lost their lives and several more were injured. The latest figures state that over 117,000 people are displaced from their homes and over two million children have been affected. Like many countries at this time, Nepal is in great need of humanitarian assistance and help in rebuilding efforts. However, disaster relief is a short-term issue. The fate of the country in the long term must be considered by the international community.

Nepal was already listed as one of the poorest countries in the world prior to the earthquake, and moving forward they will not be able to break from their rank anytime soon. However, the country does have the means to be self-sufficient with the right help.

Nepal has many natural resources, particularly minerals like zinc and copper, but they are in limited supply and hard to get to. Agriculture is the largest source of income for the country and employs the most people. Many crops grow in the region but the most popular now are rice and corn. There is great potential for agriculture in the country if they can gain access to newer methods of farming and education. Agriculture will not only help Nepal feed its people, but boost international trading potential.

In Bill and Melinda Gates’ Annual Letter that was released this week, they bet that in 15 years Africa will be able to feed itself. For those of you who have never been to Africa you may think this is an overstretch, but it is entirely true and based on significant data.

Most of the people I have met in Africa are smallholder farmers. Africa is an agrarian continent. Most people have to feed themselves from what they grow, but due to a lack of fertilizer, seeds, crop rotation, and substantial rain, farmers are suffering across the continent.

The Gates Foundation believes that in 15 years Africa can feed itself. This is a big challenge, but because they belive it so much, they fund NGOS that work on food security across the continent.

2015 will be an interesting year in global health primarily because this is the year when the Millennium Development Goals should ideally be reached. Global health experts admit that many of the goals, for example MDG5, will not be reached globally even though some of them have already been reached on a country level.

Ethiopia effectively reached MDG4 along with Bangladesh, Liberia, Malawi, Nepal, and Tanzania according to a 2013 report in the Guardianand UN data. Globally, the proportion of people having access to safe drinking water was reached in 2012. That is cause for celebration.

The overarching theme this year will be how the global health community will save more lives in low and middle-income countries in the best ways possible. This does not necessarily mean substantive goals, target dates, and data measurements will be scaled back. Rather, improved approaches to global health will be devised to streamline processes and programs.

While there are many global health stories that deserve following in great detail here are our top five picks for 2015.

1. The Effect of Ebola on Maternal Health: While Ebola is being fought in Sierra Leone, Guinea, and Liberia there must also be an enhanced emphasis on women who are pregnant and need to deliver their babies in a hospital setting. As it is, with low resources and crippled health systems in these three countries, women still need to be afforded quality care during pregnancy and delivery while health workers also care for those stricken with Ebola.

As the year goes on it is probable that key data will emerge from lessons learned during the Ebola response. According to Scientific American, the WHO, UNICEF, and Save the Children have already devised best practices and protocols for safe delivery.

2. Global Immunizations: This year we will watch the increase in rotavirus vaccine roll-outs across poor countries. Why? Diarrhea is one of the top three leading causes of deaths for children under five, and yet the rotavirus vaccine isn’t accessible in the volume of some the other vaccines. That said, rotavirus roll-outs have increased substantially since 2011. There is more good news. With increased GAVI funding, the rotavirus vaccine will be introduced in 30 countriesthis year.

We will also look at the progress of the Ebola vaccine. GAVI has announced that it is ready to purchase a million doses of the vaccine as soon as the World Health Organization approves its use. Today, Johnson & Johnson announced that they have already begun clinical Ebola vaccine trials with volunteers in Africa.

3. Country Commitments to the Every Newborn Action Plan (ENAP): Last year saw the official adoption of the plan during last year’s World Health Assembly and the launch of the Every Newborn Action Plan in Johannesburg during the Partners Forum. Upon its launch there were already 40 commitments (PDF) to save more newborns globally. That said, this year we will also look for increased commitments, particularly country commitments, to the ENAP especially since 2.9 million newborns die every year due to largely preventable causes.

4. Scaling Up of Frontline Health Workers: Did you know there is a global shortage of 7.2 million frontline health workers? That key data has been widely shown by the lack of health workers in Ebola stricken countries. It’s the lack of health workers that has made fighting Ebola harder than it should be and why many health workers outside of Africa have had to pick up the slack.

Scaling up health workers is a large expense, but it bears repeating that in order for countries to provide quality health care to their citizens there must first be enough health workers. Ethiopia is touted time and again as an excellent example of a poor country that effectively scaled health worker coverage across the country through a government-led effort. Other countries’ health ministers have traveled to Ethiopia to see best practices for scaling up their own frontline health force. The second step after key learnings, however, is making sure actions are taken besides pure lip service. In 2015 we will look at evidence from other low- and middle-income countries, particularly in sub-Saharan Africa, that will introduce better national health worker programs.

5. Food Security in Conflict Areas: At the end of 2014, the World Food Programme said that it had suspended food aid to 1.7 million refugeesin Syria due to a lack of donor funding. And previous to that, the WFP split vouchers in half to stretch funds according to the New York Times. Even though the World Food Programme received an emergency influx of funds after their voucher suspension announcement last month, it is never a good sign to see that there are not enough donor dollars to feed the world especially those who are living in conflict areas. Food security in not only conflict zones, but also in West Africa will be on our must-follow list this year.

Which global health stories are you following this year?

UN Photo/Martine Perret

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